By following strict infection prevention practices with patients who have central venous lines inserted, Columbus Regional Healthcare System (CRHS) did not have a single CLABSI (Central Line-Associated Bloodstream Infection) incident in 2016. As a result, CRHS has been recognized as a "CLABSI Top Performer" within the Carolinas Healthcare System (CHS) network.
The CHS system includes more than 7,600 licenses beds, accounts for almost 12 million patients interactions each year and offers more than 900 care locations.
CLABSI is defined as "a primary bloodstream infection where the central line or umbilical catheter was in place for more than two calendar days on the date of the event."
"Our last CLABSI incident was in November 2015," said Miranda Kamberger, RN, BSN, CIC, infection preventionist at CRHS. "That's nearly 500 days and counting."
Kamberger attributes the success to a "concerted effort from front-line staff and nursing leadership." Compliance with evidence-based practices from physicians and nurses is also critically important, she said. In fact, the hand washing compliance rate is 94 percent. In the past — when a patient experienced a CLABSI incident — the staff would perform an "event analysis" to discover contributing factors and what staff could do to reduce the risk.
Other factors that contributed to top scores include:
The goal is always to get the line removed as soon as possible. Nurses assess each day whether each patient's central line is still needed for critical medications, blood transfusions or other indications.
Even the Centers for Disease Control (CDC) acknowledges: "The goal of eliminating CLABSI or 'targeting zero' for many institutions remains difficult to both achieve and sustain. Recent research suggests that elimination of CLABSI may be most likely in ICU patients with a central catheter dwell time of less than nine days following aseptic insertion."
